Exploring the seasonal impact on appendectomy: incidence, patterns, predictors, and healthcare implication of appendectomy at Prince Ali military hospital

Abstract

Background: This study at Prince Ali military hospital in Al Karak, Jordan, investigates seasonal variations in appendicitis incidence and outcomes, assessing diagnostic and treatment strategies across different seasons. The aim is to understand how seasonal changes influence appendicitis rates and to evaluate the effectiveness of diagnostic methods and treatment approaches. Methods: A retrospective observational study was conducted on 321 confirmed cases of inflamed or perforated appendicitis from March 2021 to February 2024. Patient demographics, dates of surgery, surgical interventions, and postoperative complications were analyzed, with a focus on seasonal trends. Results: Out of 394 reviewed cases, 321 (81.47%) met the inclusion criteria, showing significant seasonal variations in appendicitis incidence. Autumn saw the highest rate of appendicitis cases at 32.09% while the lowest was in Winter (22.12%). Regarding normal appendix, the highest rate was in winter (21.98%), and the lowest was in summer (13.09%). The mean patient age was 25.20 years, with a majority being male (66.36%). Open surgeries were the most common, comprising 91.9% of cases, compared to 8.1% for laparoscopic procedures. Diagnostic analysis revealed a very strong correlation between CT findings and histopathological outcomes (p=3.23×10^-11) and a significant but less strong correlation for ultrasound findings (p=0.000446). These results suggest that both diagnostic methods are effective, with CT scans showing a stronger correlation. The distribution of cases across seasons was 32.087% in autumn, 23.05% in spring, 22.741% in summer, and 22.118% in winter. Conclusions: Significant seasonal peaks in appendicitis are evident, particularly in autumn, driven by changes in diet and viral infections. The superior effectiveness of CT scans during winter highlights the need for adaptive diagnostic strategies across seasons. These findings advocate for healthcare systems to seasonally adjust resources and diagnostics to optimize appendicitis management, with further research needed to expand these insights globally.